Response Form For Diplomatic And Consular Personnel - Nyc Department Of Finance printable pdf download

NEW YORK CITY DEPARTMENT OF FINANCE

PARKING VIOLATIONS

ADJUDICATION DIVISION

R E S P O N S E F O R M

FOR DIPLOMATIC AND CONSULAR PERSONNEL

Finance

Mail to: NYC Department of Finance, Diplomatic Parking Review Panel, 66 John Street, 3rd Floor, New York, NY 10038

Instructions: This form is provided to diplomatic and consular officials to assist in responding to a notice of parking violation issued

to vehicles with Department of State issued license plates. Please complete all sections below and submit this form to the address

above within thirty (30) days of the date the notice of parking violation was issued. Include with this form the original notice of parking

violation received along with any supporting documentation. Keep copies of everything you submit. If you have questions or require

further assistance, call the Department of Finance Diplomatic Parking Review Panel at 212-291-4697.

SECTION I. REGISTRANT INFORMATION (Please Print)

Daytime

1. Name: ___________________________________________________________ 2. Phone Number: ______________________

FIRST

LAST

3. Address: ________________________________________________________________________________________________

NUMBER AND STREET

APT

CITY

STATE

ZIP CODE

4. Mission/Consulate: ________________________________________________________________________________________

SECTION II. VEHICLE & NOTICE INFORMATION

1. I am

the registrant

the operator

a representative of the registrant or operator

(check one):

2. Vehicle

3. Vehicle

4. Number of

Plate #: _________________________

Make: ________________________

Notices Contesting: __________________

5. Fill in Each Notice Number below. (Attach Separate Sheet, if necessary.)

SECTION III. REVIEW PANAL INFORMATION (Check one and then Complete Either A or B)

I want to contest the notice(s) above:

In person (complete A)

By Mail (complete B)

A. IN-PERSON: Scheduled by appointment. Please check both the day and time you prefer. You will receive written confirmation

of your scheduled appointment.

T uesday

Wednesday

Thursday

F riday

Monday

9am - 10am

10am - 11am

11am - 12pm

2pm - 3pm

3pm - 4pm

B. BY MAIL: Please print a clear and complete statement of why you believe you are not responsible. Include the original notice(s)

along with any supporting evidence (statements of witnesses, photographs, diagrams, etc.) Attach additional sheets if necessary.

_________________________________________________________________________________________________________

How do you want to receive the decision:

By Mail

By Fax - No.

________________________________________

SECTION IV. CERTIFICATION

Date:

______________________________________________________________________________

___________

REGISTRANT

S SIGNATURE

Date:

______________________________________________________________________________

___________

(

)

AUTHORIZED AGENT

S SIGNATURE

IF DIFFERENT THAN REGISTRANT

NOTE:

Submitting a response to the Diplomatic Parking Review Panel or the Diplomatic Parking Appeals Panel does not constitute a waiver of any

privileges or immunities to which the registrant may be entitled, nor does it constitute its acceptance of the civil or criminal jurisdiction of the City or

State of New York or their respective authorities. by responding to or otherwise contesting the validity of a notice of parking violation, or appealing an

adverse decision of the Diplomatic Parking Review Panel, a registrant has merely accepted the City's offer of consensual dispute resolution.

PVO-1200 Rev. 08.05.2013